Millions of medical specimens are collected in hospitals and clinics every day. Each specimen has to be labeled identifying the patient from whom the specimen was collected to ensure that laboratory results associated with the specimen are returned to a correct patient's file or database. It is generally desirable to include the date and time a specimen was collected, the physician order that caused the specimen to be collected and related tests that are to be performed on the specimen, and the healthcare worker who collected the specimen. In the past a paper label was prepared by hand writing the appropriate information on the front surface and then adhering the label to a medical specimen container. However, this technique is prone to error, misreading by others, and is generally unsuitable for automated laboratory equipment to recognize.
One common medical specimen is a blood sample that is normally collected in a vacuum tube. These tubes are often labeled with a manufacturer label and then with a pre-printed secondary adhesive labels that have been prepared for a specific patient. In some cases a sheet of labels is printed and used as needed when samples are collected for the patient. Where sheets of labels are employed, unfortunately, the sheet labels lack information about the healthcare worker who collects the blood sample and the date and time at which a sample is collected. The collection of blood samples is further complicated in that different blood tests require the blood to be collected into tubes with specific reagents (for example anti-clotting or clot activation chemicals) to preserve or start a reaction with the blood and when multiple tubes are to be collected the sequence of collection is important to prevent the reagent in certain tubes from contaminating samples collected in other tubes.
Another concern about the use of hand applied labels is that they can be put on crooked, upside down, or sideways making it much more difficult for laboratory systems to properly read identifying bar codes or other machine readable information printed on the labels. In some cases sample tubes are extremely small such that, when a label is misapplied, a portion of the label may wrap around the tube completely and obscure printed material on a different portion of the label.
Recently the Becton Dickinson Company has made some improvements in the collection of blood samples. In one case blood tubes have been introduced with color coded caps that have matched color coded labels with printed indicia along the top edge. Secondary labels are printed to identify the blood tube and typically include information identifying the patient from whom the blood sample is collected, the collection order number, and other useful information. The secondary labels can include a notch or second indicia along the top edge. A worker aligns the second indicia to the pre-adhered manufacturer label indicia on the tube. Once aligned the secondary label can be wrapped around and adhered to the blood tube in what is a fairly precise orientation.
One desirable secondary label size and alignment criteria is that a portion of the original tube label remain exposed after the secondary label is applied. For instance, in most cases it is desirable that at least a portion of the color coded section of the manufacturer label be exposed after the secondary label is applied so that the tube type can be identified after application and after the cap is removed. Similarly, in most cases it is desirable for at least a portion of the transparent portion of the tube be exposed after the secondary label is applied so that a tube user can observe the condition of the reagent and other material (e.g., a specimen) within the tube after label application. Blood collection tubes are typically 13 mm in diameter and 75 mm in height, allowing for a secondary identification label that is less than 40 mm wide (typically 33 mm wide) and 55 mm high so that when the narrow part of the label is wrapped around the tube (with a diameter of 40.8 mm) a portion of the transparent tube remains unobstructed for viewing.
Another, improvement that has been developed includes a printer that can print blood sample secondary labels at the bedside of a patient. In known embodiments a printer can add the time and can read a bar code corresponding to a patient (e.g., from a wrist band or the like) to the get the patient identification number and even a healthcare worker identification bar code to get a healthcare worker identity number, all of which can be printed using the printer.
Unfortunately, even in the case of bedside printers and color coded specimen tubes, there is still the opportunity for a secondary label to be attached in a misaligned fashion to a tube, for a label to be attached to the wrong type of tube or for a secondary label for a first patient to be inadvertently attached to a tube that includes a specimen from a second patient. Here, where a labeling error occurs, a laboratory processing a blood sample (or other specimen type) may associate the results with the wrong patient in a medical record.
Blood tubes are not the only container that needs to be carefully labeled. There are a variety of body fluid and other samples that are collected and need to be carefully labeled to ensure that a laboratory can associate the samples correctly with patients.
There are also a variety of other containers in healthcare that need to be carefully labeled, for example medication containers or vials. As in the case of specimen tubes, medication vials are often relatively small relative to the amount of human readable text and bar codes that are to printed on them.
The proper labeling and using of non-medical containers and objects is also of great importance.
There are many instances where individuals wish to transport items between locations and track the whereabouts of the items, who is entitled to have access to the items, and other pertinent information. For example, medication prescribed by a physician in a hospital for a patient can be dispensed either manually by a pharmacist or by a unit dose dispensing system in the pharmacy or placed at various locations in the hospital for nurses to use. In the case of manual dispensing, a medication order is sent to the pharmacy where the correct medication is selected or formulated. The medication is then placed in a container, plastic bag, or envelope which is in turn labeled with identification information specifying the patient that is to receive the medication as well as information about the medication dispensed. Such labeling can be achieved by the use of a marking pen or a computer printer adhesive label.
A variety of devices have been invented and several placed in commercial production for the dispensing of unit dosages of medication. These systems are often designed to be placed in a variety of locations in a hospital for local and convenient dispensing of medications. A key advantage of these systems is a reduction in time and labor in the delivery of prescribed medication to a patient. Without such systems, each prescribed medication must be dispensed by the central hospital pharmacy, labeled, and transported to the nurses station near the patient's room. This process must be done 24 hours a day and the dispensing must be done in anticipation of when each new dosage is due with an allowance for time spent in transmit. Unit dosage dispensing systems usually have a tray or cartridge that is loaded with multiple dosages of medication by the central pharmacy. This tray or cartridge is then carried to the unit dosage dispensing system where it is inserted, along with information regarding the medication in the tray or cartridge. This information usually includes the medication name and the number of doses contained. When a patient is to receive medication the nurse usually must use a mechanical key, an electronic key, or a computer password to gain access to the dispensing process. The nurse will identify the medication and may identify the patient to receive the medication. The dispensing system then locates the correct tray or cartridge containing the desired medication and then removes one or more doses of the medication as required, typically delivering them to a drawer or door that the nurse may open to remove the medication.
After dispensing the nurse carries the medication to the patient for consumption. The dispensing system can keep track of the date and time when the medication was dispensed, for which patient it was for, and possibly the nurse to whom it was dispensed. However, the dispensing system cannot determine if the medication was in fact given, if it was given later, who gave it to the patient, or if it was given to the correct patient.
Several studies have documented that most medications in a hospital are given to the correct patient. However, the small percentage of medications that are given to the wrong patient is cause for great concern. This can happen if a patient is moved from one room to another and a new patient is now in the former patient's bed. Occasionally, the former patient's name may be left written on a board near the bed or by the doorway. While nurses are suppose to verify the patient's name or identification number written on a bracelet each time they administer a medication, this may not always happen. The nurse may receive a call to go to an emergency while giving a medication and thus be rushed, the patient may be unable to speak to identify themselves, or the nurse may not want to disturb a patient who is sleeping. Errors in giving medication to the wrong patient can cause a variety of reactions that can sometimes lead to death.
To track when a patient was given medication and who gave it, hospitals employ either manual or computerized recording systems. Manual systems are time consuming and can cause errors in patient billing. Even with computerized record systems, the nurse must spend some amount of time entering and verifying the information. It is claimed that within a hospital that over 60% of all expenses are related to nursing, and of that nearly half of this is for nurses to fill out paperwork and write observations. With continuing efforts to control the rising cost of providing health care, hospitals need to explore all methods possible to reduce nurse time spent away from directly caring for patients.
Problems such as these can occur in other situations, both in hospital settings and elsewhere. For example, hospital personnel may want to store the personal belongings of a particular patient while the patient is receiving treatment and need to identify the belongings so that they are returned to the appropriate patient. Similarly, when medical personnel desire to dispense fluid medication, either in the form of an intravenous solution or medication to be taken orally, they must keep track of how much and what type of fluid is being dispensed and which patients have received their medication. In each of these cases, it can be very time consuming to write down the type and quantity of substances being identified, who is accessing the substances, what time the transaction is taking place and other important information in order to ensure that the task is being performed correctly.
Problems such as these can go far beyond the medical field. In the manufacturing industry, for instance, it is often important to keep adequate records of individual components. For example, if a particular prototype device or key part is being transported from one place to another, and only a few qualified individuals are supposed to have access to the component, or the component is only to be delivered to a particular location or process, it is important to have a system for ensuring that only the proper individuals are allowed to access the component. It may also be important to record the time at which the component is delivered to its destination, where it is currently located, and similar pertinent information.
Although these problems may appear to be particular to certain industries, the common theme between them all is that there is a need for tracking and permitting access to certain objects, recording relevant information, and doing so with minimum expense, time, and effort.
The present invention is intended to solve these and other problems.